Innovative Pharmacy Solutions (ft. Vinay Patel)

Thanks for tuning to Digital Voices Podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now your host, Ed Marx.

Welcome to Digital Voices. Thank you for making us number 9 on the Apple charts. So for technology, we're really excited about it. And the only reason that we're ranked that highly is because we have most excellent guests like Vinay Patel. Vinay, welcome to Digital Voices.

Ed, thank you so much for having me. It's an honor to be here on your very popular healthcare podcast.

Yeah, we're— it's kind of funny how it sort of happened over the years, but again, it goes back to the guests. And we don't have any commercials, ads, or sponsors, so it's just content. So I know when I'm running, I can't stand it. I'll stop listening to some of those podcasts because I don't want to listen to commercials while I'm suffering, you know. So anyways, this is a great topic on sort of pharmacy and related because we don't cover this very much on Digital Voices. So I'm super happy to have you be part of that. We're gonna be talking about MakoRx and we'll get into that in a minute. But the most important thing, Vinay, that we talk about are what songs are on your playlist? What kind of music do you like to listen to?

So I have this ongoing playlist on my music app that I've been curating for I think right after the pandemic, and it's called the Inspirational Playlist, and it's for all of my family members to add any song that's positive and uplifting and encouraging and increases your confidence. And I really like that. It's gotten really unwieldy. It's really long. There's a lot of songs on there, but every time I listen to it, I'm like, wow, these are, you know, just when you're down or when someone in the car is just not feeling right, we're like, all right, we'll listen to this playlist. So it's kind of just, You know, a wide variety of songs on there. Everything from country to pop, a lot of pop. We listen to a lot of pop songs and some Disney songs on there. It's just, it's just a mix of everything.

I love that concept. That's a good one. I might have to do that with my family as well. I hadn't heard that before. I really liked that quite a bit. What about life message or mantra? Are there words that you try to live, live by?

I, I do. Be positive. See the kindness in others and understand everyone else's perspective. That's super key to just, you know, in today's sort of digital environment that everyone's grown up since we've had these computers in our pocket, it seems like our attention spans are getting shorter and shorter and listening very carefully and understanding others just has a lot more meaning than it used to.

Yeah. That's true. I like those a lot. We're also developing— we haven't released it yet, but everyone's sort of mantra after 200, over 250 recordings. We've got a lot of different life messages and mantras, and we're going to put that, stitch that all together.

Oh, cool.

Yeah. So, Vinay, let's talk about you. Let's talk about who are you, like, what's your story? Tell us about your life growing up.

You know, it's, uh, I grew up in South Florida near West Palm Beach, Miami, and it was just a standard middle-class, you know, house with my parents who worked really hard. My mom was an accountant and my dad was a chemist and technician. And what was really cool was to see my mom work really hard at what she did. She took care of everyone in the family and her job. Looking back now as a parent, I realize how much she actually did.

Wow.

just so grateful for that. But then, you know, on the flip side, my father, when I was growing up, right when I finished high school, he lost his job that he'd had for about 20 years, and he didn't know how to do anything else. But what I saw in him was that he just picked up and learned something brand new, completely new, outside of his field, got a new job. And it taught me that it doesn't matter how old you are, you're always ready to learn new things and absorb new messages. So it was really neat. Didn't get to spend as much time on the beach as As I now miss being away from the beach. But it was a great place and it sort of just set the foundation. You know, went to school in Florida as well, became a pharmacist there. Knew I wanted to be a pharmacist in high school. I have no idea why. I originally wanted to be an engineer, computer programmer, like most kids that were nerds back in the day. But then after that fell through in high school, I said, okay, let's just randomly. And then when I got into pharmacy school, realized how much I liked it and enjoyed it and helping other people. So, so that was really, you know, growing up, it was just, just your normal ho-hum middle class.

My wife is a DNP. She said her hardest course was pharmacology.

We had 4 years straight of pharmacology.

Yeah, it's pretty intense. But I'm glad there's people like you that, you know, are passionate about it, really know it well, because obviously it helps many different people. Now, you went on, you didn't do just sort of a traditional pharmacist. Yeah. You started some Companies along the way, right? Can you share a little bit about that?

We did. So group of— so after working in various areas of pharmacy, after getting outta pharmacy school, health systems and retail pharmacy, independent pharmacy, taught at academic university medical centers and medical residents and medical students and pharmacy students, sort of this invisible hand of the pharmacy benefits company was wherever I went, It told you what you could do, how much you could make as a pharmacy, and really quite restrictive, similar to what medical providers go through in the medical insurance world. And so we decided, a group of myself and some pharmacists got together and said, we're going to come up with a company that's going to do the exact opposite. And what we pioneered back in 2018 was a cost-plus pharmacy benefits program hadn't existed before in the commercial space. And we wanted to focus and really have at our core independent local pharmacies, mom-and-pop pharmacies that most people didn't know about or weren't aware of because their insurance company sort of guided you towards the big box stores. And that's what we created as sort of our first company that evolved and merged into what is now MakoRx. And we've done many other things since then, but our core has been serving the employer market, the self-funded employer market, showing them that pharmacy doesn't have to be as complex and as unaffordable as it is today with just part of our model being cost plus, but then also incentivizing generics for our members at low cost, no cost, and then also helping employers save on these high-cost drugs like specialty and brand products through savings programs that we built.

Yeah, I love that. Well, tell us about the name MakoRx.

So the founder of— so our parent company is a lab and it's called Mako Medical Labs. And the founder of that company really wanted a brand because there were behemoths in the lab space, LabCorp and Quest. They viewed them as whales, just slow moving, gentle creatures, status quo. And these guys wanted to be the shark, nimble, fast, hungry.

Yeah.

Indomitable. And so they came up with this shark logo and the company was called Mako Medical. So when we came on as the pharmacy program, it was Okay, yeah, yeah, I like that. It makes a lot of sense.

And so your message has really resonated in the marketplace. Share an example or two of organizations that were like, yeah, this is a differentiator, we really need to work with MACORx.

You know, we work with about 35 different companies today. We serve about 5,000 members, mostly here in North Carolina, but we have a great group we service out of Illinois as well. And it's all of these mostly blue-collar jobs. We've got manufacturing plants, we have construction companies, auto dealerships, we have car care centers, auto mechanic shops. And, you know, it's the underserved market. We're talking about smaller groups, under 500, that really just don't get enough attention. attention and don't have the resources internally at these companies to figure out benefits. And we teamed up with a health plan here in North Carolina called Hero Health Plans, and they were providing the medical benefit and sort of medical guidance, um, navigation. We were doing all the pharmacy benefits and pharmacy navigation. And what we realized is by teaming up, we could tell companies, you know, you can replace your insurance card, whether it's Aetna, Cigna, you don't have to worry about it. We, we tried for the longest time just sell pharmacy benefits. And that was incredibly difficult. There were so many barriers.

Yeah.

That we learned along the way. And so by combining forces, we were able to go in and really make a difference with companies because they didn't have to worry about different components. We had the full-stack solution for them. And initially what we saw is members would tell us when we would go to them is, I didn't know that I could use my local independent pharmacy because all the time when I got insurance, it was always go to either mail order Or go to the big box stores as sort of the default. And they said, I realized how much better customer service I got there, better quality of care. They were sort of, they looked out for me, they were advocating for me and they knew my family and called doctor's office if we needed for any problems or issues. And then we get better prices now because we were incentivizing them to go to these local mom-and-pop pharmacies. We had access to every pharmacy in the country, but they would get incentives to go to the local mom-and-pop pharmacy. And that was really the first win was everyone was excited about reconnecting with these mom-and-pop pharmacies they really didn't know about in their communities. And then getting incentives on lower, lower, no-cost generics. And then the employers after a year, after 2 years realized that they were saving 30 to 40% on their pharmacy benefits through the cost-plus modeling and the incentives we had around generics and biosimilars, so on and so forth.

Wow.

And so that was a, that was a huge win as well. And that sort of made the package and then word of mouth got around and we were able to grow from there.

Yeah. So not only getting the cost savings, but it's a better user experience, if you will, customer experience. And it's sort of local, right? Because you are using, you can use your local pharmacy and that, that's always a good thing whenever you reinvest in your own community. I know my wife's a clinician. And she also prefers for her supplies and everything going to local pharmacies. And she's just for the same reasons that you would as a patient. And so, yeah, so I definitely see the power around this model. And I know you mentioned it earlier, you're sort of disintermediating in a way, right? There's this middle, this middle piece, this layer that adds on cost, but not necessarily value. And so, yeah, that's what sort of drives you, your company, sort of the passion around this.

Yeah, that's right. That's exactly right. And we continue to evolve now as well through our next phase. Yeah.

And I think people are starting to realize as the cost of healthcare just has gone out of control, right? And we're not seeing the level of quality and safety commensurate with That increase over the years that people are, are sort of questioning things and relooking at, wow, maybe we should do things a little different. And what you all are doing is, is one of those things that people can lever to reduce costs and at the same time improve the experience, improve quality, I imagine is the same or better. And then again, from a local economy point of view, it's, it's really good to do that reinvestment.

That's right.

So you've done a lot of these sort of things. You've built some companies. So you, you have a lot of leadership. Was there anything that happened early in life? You already talked about your dad a little bit, his situation. But that helped prepare you for your leadership roles?

Uh, let's see, after I came here to North Carolina, I got a job at a home delivery pharmacy that served members in about 7 different states. And that was my first sort of mentor that was my supervisor. And I was— my first time in middle management, it was the hardest job I ever had. And my supervisor at that time gave me some great pieces of advice that would serve me well and sort of developed how I think about leadership and how I treat people. And that was really powerful, sort of the first time that I got exposed to someone that had some great leadership skills and that was able to teach them to me, or at least embed some of those frameworks into my head. And then I also started reading a lot about leadership when I got into that role.

Yeah.

And those books helped out some as well.

Yeah, that'll certainly push you that direction when you suddenly find yourself as a leader in a leadership role. And you're like, oh my gosh, what do I do? And there's some great resources out there for sure. Would you recommend, or do you think they've added it now in the PharmD curriculum, like sort of leadership, or is it still all sort of science-based?

I don't know about leadership specifically, but there is more focus and time and class spent on the business of healthcare, which is so important for every clinician to know. They have some leadership components in there, but I really don't know now compared to Geez, 20 years ago when I went to pharmacy school, if they have 20, 25 years ago, whether they have specific leadership courses.

Yeah, it would be interesting too. Similar question, but on the tech side, I know in nursing, you know, it's been slow to add that sort of topics in the curriculum. And obviously everything is tech now. So it'd be good to have a lot of leadership and a lot of tech, you know, whether it's PharmD or DNP or whatever advanced clinical education, it'd be great to also complement that with sort of the business because that's where most, you know, a lot of times when people are getting the higher levels of education, they're often moving into leadership type roles and having that background would be helpful.

Yeah, absolutely. The earlier we can start that training and the earlier that we can get people to understand the principles of leadership, it just, it makes the, it's going to make healthcare all the better.

Yeah, absolutely. What about advice for other healthcare professionals? Maybe there's somebody, it doesn't have to be a pharmacist, but we'll just start with that since that's your background. You know, they're looking, they have an idea and they're looking maybe just do a startup or something. What's one or two pieces of advice you might give them?

Everyone has their own unique situation, but starting something on your own is and will always be the scariest thing you all, you do. And it's important to have good colleagues and family that can support you through it.

Yes.

There's nothing you can do to get around it. It's going to be frightening. Some people are born with it and they love the thrill, but most clinicians I know, they're sort of this sort of standard, follow the rules. And we are trained not to make any mistakes because we're taking care of people's lives. And you gotta remove that perspective and start thinking like a scientist. If you understand that scientists think about all these hypotheses and then they test them out, is essentially what you're doing in business is you're testing all these hypotheses out, you gotta learn from that. There's gotta be a feedback loop and then you gotta change. You can't just stick to this and sort of be bullheaded and just stick to one path. And as you learn, change your path and adapt and use that scientific method to really take care of that. But make the leap if you can, make the leap. If you can't, join organizations that give you some fulfillment in making a change in healthcare, if that's really what you're thinking about.

Yeah, no, that's, that's sage advice. Vinay, you have a long way still to go in your career, but so far, what are one or two things that you're most proud of?

That's a great question, Ed. I'm super excited about the work that we've done, myself and our team here at MakorX. We've helped thousands of people, first and foremost patients and companies, realize that healthcare can be simpler, it can be lower cost, and it can still still be high quality. And we've created so many products. A lot of those products just never panned out, but we tried them. We tried pharmacy services, cash pay services at pharmacies, and the program that we set up for that. We've come up with drug savings programs no one else has really thought of or created before, and we've implemented those, and some are successful, some have failed. And, you know, creating this model and being sort of a contrarian to the status quo model is really— it takes a team.

Yeah.

You can't do it alone. It's not just us. It takes partners in this ecosystem. It's going to really— and this is something I say all the time— it's going to take all of us to change a system that just doesn't work anymore for the people that need it the most, our patients.

Yeah, well, that's well said. You've already alluded to this quite a bit because the life and role of an entrepreneur is not an easy way. You know, what's one thing that you've learned the hard way, maybe something that you didn't anticipate?

I really didn't value time as much as I do today. I don't know if it's just a factor of being older or if it was the journey that I took, and it's changed my complete perspective on we don't have enough time. I used to take it for granted and think we had all the time in the world and really didn't optimize it and wasted a lot of it. Looking back, I feel like I wasted a lot of that. time. But I learned it the hard way because it took me— I see some of my peers, some of my friends who've started companies in their 20s and early 30s, and it took me a lot longer to have that, I guess, to find, you know, all the right alignment of getting there. But valuing time was something I learned the hard way.

Yeah. Well, at least you got it now. Yeah, exactly. Or, you know, you're on your deathbed or something like that.

Make every moment count.

Yes.

Yeah, make every moment count.

How do you recharge your batteries and remain fresh? Obviously, being part of this organization, you know, you've put a lot of time and effort into it and, you know, you have a busy life otherwise. What do you do to sort of relax?

First is perspective. You got— I keep telling myself every day, I'm running a marathon, not a sprint. You don't have to get everything done every day. And then when I get home, I love spending time with my family, just being around them and playing games. We play a lot of board games. card games at home. That really helps. My wife has taken on quite a few hobbies that I've now absorbed. Every time she's got a project around the house, I'm excited to help her, whether that's carpentry work or construction work. And then she does quite a bit of gardening and I help her out with that. And then finally, travel. As a family, we love to travel and we usually take 1 or 2 international trips a year. And otherwise, we're just, you know, meeting family around the country and that really helps.

Yeah, that's great. Yeah, it's great to have shared hobbies with your partner and things like that. What's your favorite destination to travel to internationally?

Favorite? Um, that's a really hard one. I've been to quite a few places I've really enjoyed, but I'll tell you about my last trip. We just took over spring break. We went to Iceland, and if you've never been, everyone should go. But it's probably what I've told everyone is It's a one-in-multiple-lifetime trip. The country is so expensive, but absolutely gorgeous. Ice-capped mountains that have waterfalls flowing out of them. You're like, where's the water coming from? And huge, huge mountains, volcanic activity. And then the place that I enjoyed most going on the island was a place called Diamond Beach. It's this glacier that's essentially breaking off into a river that flows into the ocean, and the ocean's just pushing all these chunks, large chunks of ice. Onto this black sand beach that's volcanic soil. And that was some pretty cool pictures. And just see the ocean, these huge icebergs, and then this like, you know, breaking apart iceberg or glacier that's sort of going into this river is pretty cool.

Yeah, no, that does sound super compelling. Maybe we'll put that as the thumbnail on this particular episode of Digital Voices. No, that's really intriguing. Look, Vinay, I really appreciate you sharing with us. You know, we talked about a lot of different things, everything from music. I love that shared playlist idea. And we talked about your life messages and mantra that sort of keep you focused and learn a little bit about yourself growing up and going into pharmacy, becoming a pharmacist and, and some of the different roles. And then finally about MakoRx and how you got into that and what you all do, really trying to disrupt the way the current state is, because like we've talked about, it's very inefficient. It's very expensive. It hasn't really changed much and there needs to be change for obvious reasons of doing that. Then we spent a fair amount of time on leadership and different things that you can do to continue your growth and, and learn, and then what it's like to do a startup. And then some of the things that you're really proud of and, and things that you learned the hard way and how you recharge and stay fresh, which is really important. Otherwise, why we all get burned out and things like that.

Yeah.

Uh, what did we miss or is there anything you wanna double down on? I'll give you the last word.

I'm really excited about the future and the future of pharmacy care and health healthcare in general. I know it sounds like today what we experience in healthcare is just sort of despair, but the future, what we see as the future is pharmacy integrating on a care team to really be part of that whole holistic approach to help patients get better care, get savings on their drug costs, work and consult directly with patients to really give the knowledge that we have more so than the service of getting a medication to a patient is the future. And we already are evolving there. Our next iteration now that we're embarking on this year is our parent company's completed a merger with ProactiveMD, and now we are offering virtual pharmacist services, consultation services to patients in employer clinics. So these are primary care clinics built for employers, run and managed by ProactiveMD. And now we're embedding pharmacy services to consult with patients, educate them, help guide them to better access to drugs. outside of their health plan and some savings programs we have for employers. And then also working side by side with clinicians to be the pharmacy expert in the room to help guide them for complex cases or high-cost or high-risk claimants that really need some extra handholding. Not for the run-of-the-mill stuff that doctors can take care of.

Yeah.

But for the extra stuff. And we can do that with community pharmacies now outside of just one pharmacist in there. I think there's a whole network of pharmacies that we can embed and help plug into the system, which is sort of probably phase 4 or 5, but that's, that's where we're headed to and we're really excited about that.

Yeah, I love that. That's definitely a great way to scale and again, provide those services in a different cost model and different delivery model. It's great. Vinay, thank you so much for being a guest on Digital Voices.

Ed, thanks so much for having me.

Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating And most importantly, thanks again for listening.

Thank you.